Chronic heart failure is a clinical syndrome and the common end pathway of many cardiovascular diseases such as coronary artery disease and hypertension. It affects over 5 million people in the US, and is the most common hospitalization diagnosis among the Medicare population, costing an estimated $32 billion per year.While pharmaceuticals and medical devices have improved patient lives, many continue to suffer and the natural course of disease is progressively debilitating.With a growing appreciation for patient-centered outcomes, and recognition that patient experience is just as important as physiological tests and measurements, many studies have utilized mixed methods, combining both quantitative and qualitative data for a more comprehensive assessment. In this context a qualitative sub-study was utilized to expand upon the quantitative clinical trial data.
The mean age (±SD) of participants was 68±9 years, baseline ejection fraction 29±7%, and median New York Heart Association class 2 HF. We idenitifed themes related to the patient's experience of illness, perceptions of self, and relationship to others. Specific psychosocial and physical benefits were described. Common themes emerged from both groups including: social support and self-efficacy related to activity/exercise and diet. The tai chi group, however, also exhibited a more global empowerment and perceived control. Additional themes in TC included mindfulness/self-awareness, decreased stress reactivity, and renewed social role. These themes mirrored improvements in previously reported quantitative measures (quality-of-life, self-efficacy, and mood) in TC compared to control. Patients in TC also reported physical benefits (e.g., decreased pain, improved energy, endurance, flexibility).
Yeh, Gloria Y et al. “The Impact of Tai Chi Exercise on Self-Efficacy, Social Support, and Empowerment in Heart Failure: Insights from a Qualitative Sub-Study from a Randomized Controlled Trial.” PloS one vol. 11,5 e0154678. 13 May. 2016, doi:10.1371/journal.pone.0154678
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